eBulletin 7, 25 January, 2012
Vitamin D can help C and B

New research suggests that adding Vitamin D to Standard of Care Hepatitis C  treatment significantly increased the rates of rapid, early, and sustained viral responses.

This research builds on a number of research papers, published in  the last two years, that increasingly support the idea that Vitamin D has an important role in the prediction of, and potentially increasing the likelihood of, a positive response to hepatitis C treatment. Vitamin D also potentially has a positive effect on viral load of those affected by Hepatitis B.


Recent Related Papers
Saif Abu-Mouch et al,  2011 December 21; Vitamin D supplementation improves sustained virologic response in chronic hepatitis C (genotype 1)-naïve patients     World J Gastroenterol.  17(47): 5184-5190.
Published online 2011 December 21.  Key Quotes: Adding vitamin D to conventional  (SOC) therapy for treatment-naive patients with chronic HCV genotype 1 infection significantly improves the viral response


Bitteto et al, (2011) Complementary Role of Vitamin D Deficiency and the Interleukin-28B rs12979860 C/T Polymorphism in Predicting Antiviral Response in Chronic Hepatitis C, Hepatology, 53 (4) 1118-1126


  Key Quotes: There was a highly significant association between progressively lower baseline serum vitamin D levels and the rates of viral clearance.....Interestingly baseline vitamin D affects not only SVR but esrlier milestones of RVR and cEVR.........In the presence of Vitamin D deficiency , it might be preferable to correct the deficiency before starting antiviral therapy....vitamin D has emerged as a key regulator of the innate immunity response in humans......study confirms a possible role for the serum vitamin D level in predicting the outcome of antiviral therapy.....may be complementary to that of the IL-28B c\T polymorphism in correct prediction of SVR...


Baur et al, (2011) Combined effect of 25-OH vitamin D plasma levels and genetic Vitamin D Receptor (NR 1I1) variants on fibrosis progression rate in HCV patients, Liver International, October 2011  Key quotes: study demonstrates strong, significant and independant associations of low 25-OH vitamin D plasma levels and the unfavourable VDR bAt -haplotype with accelerated fibrosis progression in chronic HCV.

Gal-Tanamy, M, et al, (2011) Vitamin D: An innate Antiviral Agent Suppressing Hepatitis C Virus in Human Hepatocytes, Hepatology, 54 (5), 1570-1579  Key quotes : a direct antiviral effect of Vitamin D in an in vitro infectious virus production system.........suggesting that vitamin D has a role as a natural antiviral mediator......implies that vitamin D may have an interferon-sparing effect, thus improving antiviral treatment of HCV infected patients

Petta et al, (2010) Low Vitamin D serum Level Is Related to Severe Fibrosis and Low Responsiveness to Inteferon-Based Therapy in Genotype 1 Chronic Hepatitis C, hepatology, 51 (4), 1158-1167  Key quote: ....suggesting a relation of vitamin D status with the severity of liver disease and response to therapy....                                                                                                                             

Bitetto et al, (2011), Vitamin D supplementation improves response to antiviral treatment for recurrent hepatitis C, European Society for Organ Transplantation, 24, 43-50  Key Quotes : ...vitamin D deficiency predicts an unfavourable response to antivirakl treatment of RHC. Vitamin D supplementation improves the probabbility of achieving a SVR following antiviral treatment...patients with severe vitamin ~D deficiency (under 10 ng/ml) almost never achieved SVR

Pilz et al, (2011), Vitamin D, cardiovascular disease and mortality, Clinical Endocrinology, 75, 575-584   Key quotes " In epidemiological studies, low levels of 25 (OH) D are associated with increased risk of CVD and mortality. ........ meta analysis of RCTs indicate that Vitamin D may modestly reduce all cause mortality.....the overall risks and costs of Vitamin D supplementation should be weighed against the risks of untreated Vitamin D deficiency".

Small, K et al, (2011), Increased Vitamin D Levels Are Associated With Undetectable Viral Loads in Patients With Chronic Hepatitis B, Gastroenterology, 140 (5),  Supplement 1, Page S-932

The benefits of benefits

The major changes that are currently being proposed to welfare benefits could have a large impact on those affected by chronic illnesses such as Hepatitis B and C and HIV.  Hepatitis Scotland, in conjunction with HIV Scotland, and supported by Terrence Higgins Trust, is hosting a series of events throughout Scotland, to help inform those likely to be directly affected by the changes, and also any staff working with those affected. It is important that anyone who currently accesses, or may access in the future, illness and work related benefits are aware of all of their options and these events will help to raise that level of awareness and heighten knowledge of the new process for both staff and patients.

The Briefing Sessions will be held in the morning, and will be open to everyone who wants to find out information on welfare rights and reforms, and what the changes mean for people living with Blood Borne Viruses - HIV, HBV and HCV.  This is an opportunity for those affected by BBVs, and those working in the field, to gain a greater insight into the potentially serious impact of the benefits changes on people living with BBVs, who may or may not be accessing treatment.

The Focus Groups will be held in the afternoon, to gain a better understanding of current circumstances and will be an opportunity for people living with HIV, HBV and HCV, to express their views on what the changes will mean to them.  These will be facilitated by Hepatitis Scotland and HIV Scotland.  For those who do not wish to take part in focus groups there will also be an opportunity to have their opinion recorded in confidential 1:1 surveys.


Regional dates are:

 NHS Board
 Ayrshire & Arran
 Fife & Forth Valley

Posters and leaflets will be sent out shortly, please contact us if you would like to receive these for your staff and service users.


For Further Information and publicity materials please contact:

Lesley Bon, Patient Involvement Officer at Hepatitis Scotland, for more information.

email: Lesley@hepatitisscotland.org.uk

call/text 07771561890.


Vincent Maguire moves on

Hepatitis Scotland would like to thank Vince Maguire for the work he has done as a consultant to ease the transition into our current role. Vince was previously manager of the UK Hepatitis C Resource Centre and the Scottish Director of Operations for Mainliners and brought a wealth of knowledge and contacts to the role, essential ingredients when starting up a new organisation. His input was very much appreciated and we wish him well with his future consulting work.


Null responders no more?

A small Phase II clinical trial of two drugs developed by BristolMyers Squibb has shown great promise in treating those who had previously not responded to treatment with interferon and ribavirin (‘null responders’) . Treatment was successful in 4/11 of those treated with the two new drugs and in 10 out of 10 treated with a combination of the new drugs as well as inteferon and ribavirin.


Local Events 


Addaction Fife are  running an event at the Strathaern Hotel, Kirkcaldy, 22nd March focusing on BBVs.

Developing Networks, Bridging Gaps is aimed at relevant professionals and community members who are interested in learning about BBV service provision in Fife. For further details contact Marjory at m.grzywa@addaction.org.uk or tel 01382 206 888 (Wednesday – Friday)


 Forth Valley Event
NHS Forth Valley are holding an educational study day on Blood Borne Viruses aimed at professionals working in the field. The event will take place on Thursday the 2nd February at the Falkirk Stadium between 9am and 4pm.  This should be an informative and interesting event focusing amongst other things on safe sex, drugs and Melanotan - as well as all things BBV - with expert speakers from across the field. What's more is that it's free! So feel free to come along! Places are limited so book yours by contacting Wendy Davitt at wendy.davitt@nhs.net


Taking out the fat and C'ing it starve

 A novel way of potentially blocking the replication of Hepatitis C virus has been developed by researchers in Canada, targetting the fat cells in the liver and essentially starving the virus and stopping its growth.

Targetting HCV in this way may avoid the resistance this easily mutating virus can build against treatments targetting the virus itself.

Proving a point, British vaccine makes a mark

 An early clinical trial of a new Hepatitis C vaccine has shown 'promising results' according to researchers at Oxford University.  The prospective vaccine is the first to have been trialed on human patients, differing from a recent trial conducted by French researchers.




This issue of the bulletin demonstrates key aspects of Hepatitis Scotland's current workplan. The benefits events are a result of a groundswell of enquiries regarding the impact of potential changes benefits on those affected by viral hepatitis.


The research highlighted includes potentially practice-enhancing research in relation to the benefits of Vitamin D. This adds to the voices of key UK Public Health scientists currently highlighting Vitamin D's benefits across a range of health areas. With the health of older substance users often being compromised, even without the complications caused by Viral Hepatitis , there is a growing evidence base suggesting we seriously consider Vitamin D's efficacy as an adjunct to Hepatitis treatment.



Hepatitis Scotland
91 Mitchell Street
G1 3LN

Telephone: 0141 225 0419
Fax: 0141 248 6414